Social Psychiatry and Psychiatric Epidemiology

, Volume 47, Issue 9, pp 1401–1408 | Cite as

The use of coercive measures in adolescent psychiatric inpatient treatment: a nation-wide register study

  • Siponen Ulla
  • Välimäki Maritta
  • Kaltiala-Heino Riittakerttu
Original Paper



To evaluate the extent and trends in the use of seclusion/restraint in psychiatric inpatient treatment of adolescents aged 12–17 years in Finland.


The National Hospital Discharge Register data comprising all psychiatric inpatient treatment periods of 12- to 17 year-olds in Finland during the period 1996–2003 was used. Time trends, regional variation and patient characteristics related to the risk of being subjected to seclusion/restraint in psychiatric inpatient treatment are reported.


The average prevalence of use of seclusion and restraint was 1.71/10,000/year over the study period. Use of seclusion/restraint in adolescent psychiatric inpatient care first increased, peaking in 1999–2001, and then decreased. The decrease occurred after stricter legislative control of use of seclusion/restraint was introduced in 2002, despite that involuntary treatment periods did not decrease. Considerable regional variation was seen in the use of seclusion/restraint. A greater proportion of girls than boys were secluded/restrained. Seclusion/restraint was most common in schizophrenia, mood disorders and conduct disorder.


Legislative control had the desired immediate impact on the use of seclusion/restraint in adolescent psychiatric inpatient care. Legislative control is, however, not strong enough to ensure homogenous practices across the country, as there is many-fold regional variation in figures for using seclusion and restraint.


Seclusion Restraint Coercion Adolescent psychiatry Health services research 


Conflict of interest



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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Siponen Ulla
    • 1
  • Välimäki Maritta
    • 1
    • 2
  • Kaltiala-Heino Riittakerttu
    • 3
    • 4
    • 5
  1. 1.Department of Nursing ScienceUniversity of TurkuTurkuFinland
  2. 2.The Hospital District of Southwest Finland, Turku University HospitalTurkuFinland
  3. 3.Department of Adolescent PsychiatryTampere University HospitalTampereFinland
  4. 4.School of MedicineUniversity of TampereUniversity of TampereFinland
  5. 5.Vanha Vaasa HospitalVaasaFinland

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